coagulation - there is a gradual increase in concentrations of Factors I, II, VII, VIII, IX and X during pregnancy. There is consumption of coagulation factors and platelets at the placental site after placental separation. These changes in concentrations of coagulation factors may predispose to thrombosis in the puerperium (especially if complicated by trauma, sepsis, or immobility).
blood volume changes - plasma volume: there is a loss of 1000 ml (approx.) after delivery (mostly due to loss at the 3rd stage). Over the next few days the volume may increase by 900-1200 ml due to transfer of fluids from the cellular compartments. Normal plasma volume is established by 6-8 weeks. - red cell volume: there is an average 14% red cell at delivery. Normal values are achieved at about 8 weeks.
haemodynamic changes - cardiac output: this is elevated in pregnancy and has returned to normal by 6 weeks. - heart rate: this has returned to normal values by about 6 weeks. - blood pressure: returns to pre-pregnancy levels early in the puerperium.
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